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Urban food insecurity and malnutrition are about more than just food

Cecilia Tacoli

16 Oct 2019

Food insecurity, malnutrition and obesity are increasingly becoming urban issues, affecting the health of millions of children and adults. The new issue of Environment & Urbanization looks at the wider context of urban food and nutrition security and the challenges for policymakers.

Urban poverty and poor diets are inextricably linked. With most of the world’s population now living in urban centres, and particularly in the burgeoning cities of the global South, it is imperative to understand the reasons behind a lack of access to healthy diets. The problems of food insecurity and malnutrition are driven by both the income and non-income dimensions of urban poverty.

The urbanisation of food insecurity and malnutrition

After decades of decline, global hunger is increasing. In 2019, UN agencies estimate that more than 2 billion people do not have regular access to safe, nutritious and sufficient food, and more than 820 million – one out of every nine people – face chronic food deprivation.

At the same time, overweight and obesity continue to increase, especially among adults and school-age children. This is now described as an epidemic: more than one in eight adults is obese.

This ‘new’ form of malnutrition is concentrated in cities and towns. Urban areas are home to the majority of overweight and obese adults and one in three stunted children. To achieve Sustainable Development Goal target 2.2 of eliminating all forms of malnutrition, we need to understand and address what drives malnutrition in urban areas.

Households that depend on low and irregular incomes are vulnerable to frequent accidents, illnesses and also, increasingly, floods and heatwaves. If for any reason the main family earner cannot work, there will be no food on the table that day.

Both income and non-income factors exacerbate hunger and malnutrition. People living in small towns in Uganda access their food from the same sources, regardless of income. But better off residents can buy staples in bulk at cheaper prices. In Bangalore (not open access), the more food insecure residents are also those who lack access to piped water and adequate housing and are often recent migrants to the city with limited support networks.

Bacterial and agrochemical contamination are the source of growing anxiety about food safety for consumers, local authorities and policymakers. In many cities food safety is a key driver of plans to ‘modernise’ food distribution.

In Hanoi, by 2025 the existing 67 permanent traditional markets, the main source of fresh fruit and vegetables, will be replaced by 1,000 supermarkets that are deemed to have higher food safety standards – but also sell cheap processed and ultra-processed foods.

But urban planners’ assumptions are misguided: food sold in formal urban markets may be perceived as safer but may actually have lower compliance with safety standards than food sold in informal markets.

Informal markets and street vendors are also in many cases the main source of food for the large proportion of residents of low-income settlements of cities of the global South, and for good reasons: they are often strategically located along key transport routes so people can buy dinner on their way home from work – and this is very important for those who rely on daily wages.

They offer cheap products in small quantities so there is no need for storage space, a key advantage for the many tenants who often share a single room.

Food concerns hit women harder

Food-related roles are heavily gendered. It is almost always women who know how to stretch meagre budgets to feed several people, often at a high cost of their time and energy. It is not unusual for women to go hungry in order to feed their families.

Women are also more knowledgeable than men about microbial risk and good hygiene practices, both within the home and in their work as food traders and producers (not open access). While nutrition education is important, it needs to be supported by actions that acknowledge and address the additional burdens faced by women.

Ending all forms of malnutrition (SDG target 2.2) and achieving food and nutrition security in urban contexts requires a wide set of policy responses that go beyond food to address the multiple dimensions of urban poverty, the use of urban spaces and the social dimensions of food systems.

We must recognise the needs of low-income and marginalised groups and unpack assumptions on healthy and safe food. Failure to do so will not only miss agreed targets but may well deepen urban food insecurity and malnutrition.